US5461065A - Methods for inhibiting endometriosis - Google Patents

Methods for inhibiting endometriosis Download PDF

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Publication number
US5461065A
US5461065A US08/138,643 US13864393A US5461065A US 5461065 A US5461065 A US 5461065A US 13864393 A US13864393 A US 13864393A US 5461065 A US5461065 A US 5461065A
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United States
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compound
endometriosis
treatment
endometrial
group
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US08/138,643
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Larry J. Black
George J. Cullinan
Michael W. Draper
Charles D. Jones
David E. Seyler
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Eli Lilly and Co
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Eli Lilly and Co
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Priority to US08/138,643 priority Critical patent/US5461065A/en
Priority to UA94105917A priority patent/UA26930C2/en
Priority to EP94307528A priority patent/EP0652005B1/en
Priority to CA002118092A priority patent/CA2118092A1/en
Priority to ZA948029A priority patent/ZA948029B/en
Priority to DE69427800T priority patent/DE69427800T2/en
Priority to IL11128494A priority patent/IL111284A/en
Priority to DK94307528T priority patent/DK0652005T3/en
Priority to TW083109467A priority patent/TW296382B/zh
Priority to NO19943879A priority patent/NO311242B1/en
Priority to PH49186A priority patent/PH31261A/en
Priority to RU94036772/14A priority patent/RU2157203C2/en
Priority to KR1019940026164A priority patent/KR950010893A/en
Priority to AT94307528T priority patent/ATE203404T1/en
Priority to SI9430388T priority patent/SI0652005T1/en
Priority to NZ264677A priority patent/NZ264677A/en
Priority to ES94307528T priority patent/ES2157957T3/en
Priority to SG1996008246A priority patent/SG43319A1/en
Priority to CN94117125A priority patent/CN1049335C/en
Priority to HU9402959A priority patent/HUT71235A/en
Priority to JP6247764A priority patent/JPH07188014A/en
Priority to AU75787/94A priority patent/AU677700B2/en
Priority to CZ19942537A priority patent/CZ287246B6/en
Priority to PT94307528T priority patent/PT652005E/en
Priority to US08/422,387 priority patent/US5693656A/en
Assigned to ELI LILLY AND COMPANY reassignment ELI LILLY AND COMPANY ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DRAPER, MICHAEL W., BLACK, LARRY J., CULLINAN, GEORGE J., JONES, CHARLES D., SEYLER, DAVID E
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Publication of US5461065A publication Critical patent/US5461065A/en
Priority to GR20010401841T priority patent/GR3036971T3/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/38Heterocyclic compounds having sulfur as a ring hetero atom
    • A61K31/381Heterocyclic compounds having sulfur as a ring hetero atom having five-membered rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/38Heterocyclic compounds having sulfur as a ring hetero atom
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/4025Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil not condensed and containing further heterocyclic rings, e.g. cromakalim
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445Non condensed piperidines, e.g. piperocaine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445Non condensed piperidines, e.g. piperocaine
    • A61K31/4523Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems
    • A61K31/4535Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems containing a heterocyclic ring having sulfur as a ring hetero atom, e.g. pizotifen
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00Drugs for disorders of the urinary system
    • A61P13/02Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • A61P15/02Drugs for genital or sexual disorders; Contraceptives for disorders of the vagina
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D409/00Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms
    • C07D409/02Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings
    • C07D409/10Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings linked by a carbon chain containing aromatic rings

Definitions

  • Endometriosis is a condition of severe dysmenorrhea, which is accompanied by severe pain, bleeding into the endometrial masses or peritoneal cavity and often leads to infertility.
  • the cause of the symptoms of this condition appear to be ectopic endometrial growths which respond inappropriately to normal hormonal control and are located in inappropriate tissues. Because of the inappropriate locations for endometrial growth, the tissue seems to initiate local inflammatory-like responses causing macrophage infiltration and a cascade of events leading to initiation of the painful response.
  • the exact etiology of this disease is not well understood and its treatment by hormonal therapy is diverse, poorly defined, and marked by numerous unwanted and perhaps dangerous side effects.
  • One of the treatments for this disease is the use of low dose estrogen to suppress endometrial growth through a negative feedback effect on central gonadotropin release and subsequent ovarian production of estrogen; however, it is sometimes necessary to use continuous estrogen to control the symptons. This use of estrogen can often lead to undersirable side effects and even the risk of endometrial cancer.
  • Another treatment consists of continuous administration of progestins which induces amenorrhea and by suppressing ovarian estrogen production can cause regressions of the endometrial growths.
  • the use of chronic progestin therapy is often accompanied by the unpleasant CNS side effects of progestins and often leads to infertility due to suppression of ovarian function.
  • a third treatment consists of the administration of weak androgens, which are effective in controlling the endometriosis; however, they induce severe masculinizing effects.
  • Several of these treatments have also been implicated in causing a mild degree of bone loss with continued therapy.
  • This invention provides methods for inhibiting endometriosis, comprising administering to a human in need of treatment an effective amount of a compound of formula I ##STR3## Wherein R 1 and R 3 are independently hydrogen, --CH 3 , ##STR4## wherein Ar is optionally substituted phenyl;
  • R 2 is selected from the group consisting of pyrrolidino and piperidino; and pharmaceutically acceptable salts and solvates thereof.
  • the current invention concerns the discovery that a select group of 2-phenyl-3-aroylbenzothiophenes (benzothiophenes), those of formula I, are useful for inhibiting endometriosis.
  • the methods of treatment provided by this invention are practiced by administering to a human in need of inhibition of endometriosis, a dose of a compound of formula I or a pharmaceutically acceptable salt or solvate thereof, that is effective to inhibit endometriosis.
  • inhibit is defined to include its generally accepted meaning which includes prophylactically treating a human subject to incurring endometriosis, and holding in check and/or treating existing endometriosis.
  • the present method includes both medical therapeutic and/or prophylactic treatment, as appropriate.
  • the compound is formulated with common excipients, diluents or carriers, and compressed into tablets, or formulated as elixirs or solutions for convenient oral administration, or administered by the intramuscular or intravenous routes.
  • the compounds can be administered transdermally, and may be formulated as sustained release dosage forms and the like.
  • the compounds used in the methods of the current invention can be made according to established procedures, such as those detailed in U.S. Pat. Nos. 4,133,814, 4,418,068, and 4,380,635 all of which are incorporated by reference herein.
  • the process starts with a benzo[b]thiophene having a 6-hydroxyl group and a 2-(4-hydroxyphenyl) group.
  • the starting compound is protected, alkylated, and deprotected to form the formula I compounds. Examples of the preparation of such compounds are provided in the U.S. patents discussed above.
  • Substituted phenyl includes phenyl substituted once or twice with C 1 -C 6 alkyl, C 1 -C 4 alkoxy, hydroxy, nitro, chloro, fluoro, or tri(chloro or fluoro)methyl.
  • the compounds used in the methods of this invention form pharmaceutically acceptable acid and base addition salts with a wide variety of organic and inorganic acids and bases and include the physiologically acceptable salts which are often used in pharmaceutical chemistry. Such salts are also part of this invention.
  • Typical inorganic acids used to form such salts include hydrochloric, hydrobromic, hydroiodic, nitric, sulfuric, phosphoric, hypophosphoric and the like.
  • Such pharmaceutically acceptable salts thus include acetate, phenylacetate, trifluoroacetate, acrylate, ascorbate, benzoate, chlorobenzoate, dinitrobenzoate, hydroxybenzoate, methoxybenzoate, methylbenzoate, o-acetoxybenzoate, naphthalene-2-benzoate, bromide, isobutyrate, phenylbutyrate, ⁇ -hydroxybutyrate, butyne-1,4-dioate, hexyne-1,4-dioate, caprate, caprylate, chloride, cinnamate, citrate, formate, fumarate, glycollate, heptanoate, hippurate, lactate, malate, maleate, hydroxymaleate, malonate, mandelate, mesylate, nicotinate, isonicotinate, nitrate, oxalate, phthalate, teraphthalate, phosphate, monohydrogenphosphat
  • the pharmaceutically acceptable acid addition salts are typically formed by reacting a compound of formula I with an equimolar or excess amount of acid.
  • the reactants are generally combined in a mutual solvent such as diethyl ether or benzene.
  • the salt normally precipitates out of solution within about one hour to 10 days and can be isolated by filtration or the solvent can be stripped off by conventional means.
  • Bases commonly used for formation of salts include ammonium hydroxide and alkali and alkaline earth metal hydroxides, carbonates and bicarbonates, as well as aliphatic and primary, secondary and tertiary amines, aliphatic diamines and hydroxy alkylamines.
  • Bases especially useful in the preparation of addition salts include ammonium hydroxide, potassium carbonate, sodium bicarbonate, calcium hydroxide, methylamine, diethylamine, ethylene diamine, cyclohexylamine and ethanolamine.
  • the pharmaceutically acceptable salts generally have enhanced solubility characteristics compared to the compound from which they are derived, and thus are often more amenable to formulation as liquids or emulsions.
  • compositions can be prepared by procedures known in the art.
  • the compounds can be formulated with common excipients, diluents, or carriers, and formed into tablets, capsules, suspensions, powders, and the like.
  • excipients, diluents, and carriers that are suitable for such formulations include the following: fillers and extenders such as starch, sugars, mannitol, and silicic derivatives; binding agents such as carboxymethyl cellulose and other cellulose derivatives, alginates, gelatin, and polyvinyl pyrrolidone; moisturizing agents such as glycerol; disintegrating agents such as calcium carbonate and sodium bicarbonate; agents for retarding dissolution such as paraffin; resorption accelerators such as quaternary ammonium compounds; surface active agents such as cetyl alcohol, glycerol monostearate; adsorptive carriers such as kaolin and bentonite; and lubricants such as talc, calcium and magnesium stearate, and solid
  • the compounds can also be formulated as elixirs or solutions for convenient oral administration or as solutions appropriate for parenteral administration, for instance by intramuscular, subcutaneous or intravenous routes. Additionally, the compounds are well suited to formulation as sustained release dosage forms and the like.
  • the formulations can be so constituted that they release the active ingredient only or preferably in a particular part of the intestinal tract, possibly over a period of time.
  • the coatings, envelopes, and protective matrices may be made, for example, from polymeric substances or waxes.
  • a compound of formula I required to inhibit endometriosis, according to this invention will depend upon the severity of the condition, the route of administration, and related factors that will be decided by the attending physician. Generally, accepted and effective daily doses will be from about 0.1 to about 1000 mg/day, and more typically from about 50 to about 200 mg/day. Such dosages will be administered to a subject in need of treatment from once to about three times each day, or more often as needed to effectively inhibit endometriosis.
  • a compound of formula I in the form of an acid addition salt, as is customary in the administration of pharmaceuticals bearing a basic group, such as the piperidino ring. It is also advantageous to administer such a compound by the oral route. For such purposes the following oral dosage forms are available.
  • Active ingredient means a compound of formula I.
  • Hard gelatin capsules are prepared using the following:
  • the ingredients are blended, passed through a No. 45 mesh U.S. sieve, and filled into hard gelatin capsules.
  • a tablet formulation is prepared using the ingredients below:
  • the components are blended and compressed to form tablets.
  • tablets each containing 0.1-1000 mg of active ingredient are made up as follows:
  • the active ingredient, starch, and cellulose are passed through a No. 45 mesh U.S. sieve and mixed thoroughly.
  • the solution of polyvinylpyrrolidone is mixed with the resultant powders which are then passed through a No. 14 mesh U.S. sieve.
  • the granules so produced are dried at 50°-60° C. and passed through a No. 18 mesh U.S. sieve.
  • the sodium carboxymethyl starch, magnesium stearate, and talc previously passed through a No. 60 U.S. sieve, are then added to the granules which, after mixing, are compressed on a tablet machine to yield tablets.
  • the medicament is passed through a No. 45 mesh U.S. sieve and mixed with the sodium carboxymethyl cellulose and syrup to form a smooth paste.
  • the benzoic acid solution, flavor, and color are diluted with some of the water and added, with stirring. Sufficient water is then added to produce the required volume.
  • animals in Groups 1 and 2 receive intraperitoneal injections of water for 14 days whereas animals in Group 3 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration.
  • animals in Group 3 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration.
  • each female is killed and the endometrial explants, adrenals, remaining uterus, and ovaries, where applicable, are removed and prepared for histological examination. The ovaries and adrenals are weighed.
  • CD strain female rats Twelve to thirty adult CD strain female rats are used as test animals. They are divided into two equal groups. The estrous cycle of all animals is monitored. On the day of proestrus surgery is performed on each female. Females in each group have the left uterine horn removed, sectioned into small squares, and the squares are loosely sutured at various sites adjacent to the mesenteric blood flow.
  • animals assigned to Group 1 receive intraperitoneal injections of water for 21 days whereas animals in Group 2 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration.
  • animals assigned to Group 1 receive intraperitoneal injections of water for 21 days whereas animals in Group 2 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration.
  • each female is killed and the endometrial explants and adrenals are removed and weighed. The explants are measured as an indication of growth. Estrous cycles are monitored.
  • Autographs of endometrial tissue are used to induce endometriosis in rats and/or rabbits.
  • Female animals at reproductive maturity undergo bilateral oophorectomy and estrogen is supplied exogenously thus providing a specific and constant level of hormone.
  • Autologous endometrial tissue is implanted in the peritoneum of 5-150 animals and estrogen supplied to induce growth of the explanted tissue.
  • Treatment consisting of a compound of the invention is supplied by gastric lavage on a daily basis for 3-16 weeks and implants are removed and measured for growth or regression. At the time of sacrifice, the intact horn of the uterus is harvested to assess status of endometrium.
  • Tissue from human endometrial lesions is implanted into the peritoneum of sexually mature, castrated female nude mice. Exogenous estrogen is supplied to induce growth of the explanted tissue. In some cases the harvested endometrial cells are cultured in vitro prior to implantation. Treatment consisting of a compound of the invention is supplied by gastric lavage on a daily basis for 3-16 weeks and implants are removed and measured for growth or regression. At the time of sacrifice, the uteri is harvested to assess the status of the intact endometrium.
  • Tissue from human endometrial lesions is harvested, and maintained in vitro as primary nontransformed cultures. Surgical specimens are pushed through a sterile mesh or sieve or alternately teased apart from surrounding tissue to produce a single cell suspension. Cells are maintained in media containing 10% serum and antibiotics. Rates of growth in the presence and absence of estrogen are determined. Cells are assayed for their ability to produce complement component C3 and their response to growth factors and growth hormone. In vitro cultures are assessed for their proliferative response following treatment with progestins, GnRH, a compound of the invention and vehicle. Levels of steroid hormone receptors are assessed weekly to determine whether important cell characteristics are maintained in vitro. Tissue from 5-25 patients is utilized.

Abstract

A method of inhibiting endometriosis comprising administering to a human in need of treatment an effective amount of a compound having the formula ##STR1## Wherein R1 and R3 are independently hydrogen, --CH3, ##STR2## wherein Ar is optionally substituted phenyl;
R2 is selected from the group consisting of pyrrolidine and piperidino; or a pharmaceutically acceptable salt of solvate thereof.

Description

BACKGROUND OF THE INVENTION
Endometriosis is a condition of severe dysmenorrhea, which is accompanied by severe pain, bleeding into the endometrial masses or peritoneal cavity and often leads to infertility. The cause of the symptoms of this condition appear to be ectopic endometrial growths which respond inappropriately to normal hormonal control and are located in inappropriate tissues. Because of the inappropriate locations for endometrial growth, the tissue seems to initiate local inflammatory-like responses causing macrophage infiltration and a cascade of events leading to initiation of the painful response. The exact etiology of this disease is not well understood and its treatment by hormonal therapy is diverse, poorly defined, and marked by numerous unwanted and perhaps dangerous side effects.
One of the treatments for this disease is the use of low dose estrogen to suppress endometrial growth through a negative feedback effect on central gonadotropin release and subsequent ovarian production of estrogen; however, it is sometimes necessary to use continuous estrogen to control the symptons. This use of estrogen can often lead to undersirable side effects and even the risk of endometrial cancer.
Another treatment consists of continuous administration of progestins which induces amenorrhea and by suppressing ovarian estrogen production can cause regressions of the endometrial growths. The use of chronic progestin therapy is often accompanied by the unpleasant CNS side effects of progestins and often leads to infertility due to suppression of ovarian function.
A third treatment consists of the administration of weak androgens, which are effective in controlling the endometriosis; however, they induce severe masculinizing effects. Several of these treatments have also been implicated in causing a mild degree of bone loss with continued therapy.
Therefore, new methods of treating endometriosis are desirable.
SUMMARY OF THE INVENTION
This invention provides methods for inhibiting endometriosis, comprising administering to a human in need of treatment an effective amount of a compound of formula I ##STR3## Wherein R1 and R3 are independently hydrogen, --CH3, ##STR4## wherein Ar is optionally substituted phenyl;
R2 is selected from the group consisting of pyrrolidino and piperidino; and pharmaceutically acceptable salts and solvates thereof.
DETAILED DESCRIPTION OF THE INVENTION
The current invention concerns the discovery that a select group of 2-phenyl-3-aroylbenzothiophenes (benzothiophenes), those of formula I, are useful for inhibiting endometriosis. The methods of treatment provided by this invention are practiced by administering to a human in need of inhibition of endometriosis, a dose of a compound of formula I or a pharmaceutically acceptable salt or solvate thereof, that is effective to inhibit endometriosis. The term inhibit is defined to include its generally accepted meaning which includes prophylactically treating a human subject to incurring endometriosis, and holding in check and/or treating existing endometriosis. As such, the present method includes both medical therapeutic and/or prophylactic treatment, as appropriate.
Generally, the compound is formulated with common excipients, diluents or carriers, and compressed into tablets, or formulated as elixirs or solutions for convenient oral administration, or administered by the intramuscular or intravenous routes. The compounds can be administered transdermally, and may be formulated as sustained release dosage forms and the like.
The compounds used in the methods of the current invention can be made according to established procedures, such as those detailed in U.S. Pat. Nos. 4,133,814, 4,418,068, and 4,380,635 all of which are incorporated by reference herein. In general, the process starts with a benzo[b]thiophene having a 6-hydroxyl group and a 2-(4-hydroxyphenyl) group. The starting compound is protected, alkylated, and deprotected to form the formula I compounds. Examples of the preparation of such compounds are provided in the U.S. patents discussed above. Substituted phenyl includes phenyl substituted once or twice with C1 -C6 alkyl, C1 -C4 alkoxy, hydroxy, nitro, chloro, fluoro, or tri(chloro or fluoro)methyl.
The compounds used in the methods of this invention form pharmaceutically acceptable acid and base addition salts with a wide variety of organic and inorganic acids and bases and include the physiologically acceptable salts which are often used in pharmaceutical chemistry. Such salts are also part of this invention. Typical inorganic acids used to form such salts include hydrochloric, hydrobromic, hydroiodic, nitric, sulfuric, phosphoric, hypophosphoric and the like. Salts derived from organic acids, such as aliphatic mono and dicarboxylic acids, phenyl substituted alkanoic acids, hydroxyalkanoic and hydroxyalkandioic acids, aromatic acids, aliphatic and aromatic sulfonic acids, may also be used. Such pharmaceutically acceptable salts thus include acetate, phenylacetate, trifluoroacetate, acrylate, ascorbate, benzoate, chlorobenzoate, dinitrobenzoate, hydroxybenzoate, methoxybenzoate, methylbenzoate, o-acetoxybenzoate, naphthalene-2-benzoate, bromide, isobutyrate, phenylbutyrate, β-hydroxybutyrate, butyne-1,4-dioate, hexyne-1,4-dioate, caprate, caprylate, chloride, cinnamate, citrate, formate, fumarate, glycollate, heptanoate, hippurate, lactate, malate, maleate, hydroxymaleate, malonate, mandelate, mesylate, nicotinate, isonicotinate, nitrate, oxalate, phthalate, teraphthalate, phosphate, monohydrogenphosphate, dihydrogenphosphate, metaphosphate, pyrophosphate, propiolate, propionate, phenylpropionate, salicylate, sebacate, succinate, suberate, sulfate, bisulfate, pyrosulfate, sulfite, bisulfite, sulfonate, benzene-sulfonate, p-bromophenylsulfonate, chlorobenzenesulfonate, ethanesulfonate, 2-hydroxyethanesulfonate, methanesulfonate, naphthalene-1-sulfonate, naphthalene-2-sulfonate, p-toluenesulfonate, xylenesulfonate, tartarate, and the like. A preferred salt is the hydrochloride salt.
The pharmaceutically acceptable acid addition salts are typically formed by reacting a compound of formula I with an equimolar or excess amount of acid. The reactants are generally combined in a mutual solvent such as diethyl ether or benzene. The salt normally precipitates out of solution within about one hour to 10 days and can be isolated by filtration or the solvent can be stripped off by conventional means.
Bases commonly used for formation of salts include ammonium hydroxide and alkali and alkaline earth metal hydroxides, carbonates and bicarbonates, as well as aliphatic and primary, secondary and tertiary amines, aliphatic diamines and hydroxy alkylamines. Bases especially useful in the preparation of addition salts include ammonium hydroxide, potassium carbonate, sodium bicarbonate, calcium hydroxide, methylamine, diethylamine, ethylene diamine, cyclohexylamine and ethanolamine.
The pharmaceutically acceptable salts generally have enhanced solubility characteristics compared to the compound from which they are derived, and thus are often more amenable to formulation as liquids or emulsions.
Pharmaceutical formulations can be prepared by procedures known in the art. For example, the compounds can be formulated with common excipients, diluents, or carriers, and formed into tablets, capsules, suspensions, powders, and the like. Examples of excipients, diluents, and carriers that are suitable for such formulations include the following: fillers and extenders such as starch, sugars, mannitol, and silicic derivatives; binding agents such as carboxymethyl cellulose and other cellulose derivatives, alginates, gelatin, and polyvinyl pyrrolidone; moisturizing agents such as glycerol; disintegrating agents such as calcium carbonate and sodium bicarbonate; agents for retarding dissolution such as paraffin; resorption accelerators such as quaternary ammonium compounds; surface active agents such as cetyl alcohol, glycerol monostearate; adsorptive carriers such as kaolin and bentonite; and lubricants such as talc, calcium and magnesium stearate, and solid polyethyl glycols.
The compounds can also be formulated as elixirs or solutions for convenient oral administration or as solutions appropriate for parenteral administration, for instance by intramuscular, subcutaneous or intravenous routes. Additionally, the compounds are well suited to formulation as sustained release dosage forms and the like. The formulations can be so constituted that they release the active ingredient only or preferably in a particular part of the intestinal tract, possibly over a period of time. The coatings, envelopes, and protective matrices may be made, for example, from polymeric substances or waxes.
The particular dosage of a compound of formula I required to inhibit endometriosis, according to this invention will depend upon the severity of the condition, the route of administration, and related factors that will be decided by the attending physician. Generally, accepted and effective daily doses will be from about 0.1 to about 1000 mg/day, and more typically from about 50 to about 200 mg/day. Such dosages will be administered to a subject in need of treatment from once to about three times each day, or more often as needed to effectively inhibit endometriosis.
It is usually preferred to administer a compound of formula I in the form of an acid addition salt, as is customary in the administration of pharmaceuticals bearing a basic group, such as the piperidino ring. It is also advantageous to administer such a compound by the oral route. For such purposes the following oral dosage forms are available.
Formulations
In the formulations which follow, "Active ingredient" means a compound of formula I.
Formulation 1
Gelatin Capsules
Hard gelatin capsules are prepared using the following:
______________________________________                                    
Ingredient        Quantity (mg/capsule)                                   
______________________________________                                    
Active ingredient 0.1-1000                                                
Starch, NF        0-650                                                   
Starch flowable powder                                                    
                  0-650                                                   
Silicone fluid 350 centistokes                                            
                  0-15                                                    
______________________________________                                    
The ingredients are blended, passed through a No. 45 mesh U.S. sieve, and filled into hard gelatin capsules.
Examples of specific capsule formulations of the compound of formula 1 wherein R2 is piperidino, (raloxifene), that have been made include those shown below:
Formulation 2
Raloxifene capsule
______________________________________                                    
Ingredient        Quantity (mg/capsule)                                   
______________________________________                                    
Raloxifene        1                                                       
Starch, NF        112                                                     
Starch flowable powder                                                    
                  225.3                                                   
Silicone fluid 350 centistokes                                            
                  1.7                                                     
______________________________________                                    
Formulation 3
Raloxifene capsule
______________________________________                                    
Ingredient        Quantity (mg/capsule)                                   
______________________________________                                    
Raloxifene        5                                                       
Starch, NF        108                                                     
Starch flowable powder                                                    
                  225.3                                                   
Silicone fluid 350 centistokes                                            
                  1.7                                                     
______________________________________                                    
Formulation 4
Raloxifene capsule
______________________________________                                    
Ingredient        Quantity (mg/capsule)                                   
______________________________________                                    
Raloxifene        10                                                      
Starch, NF        103                                                     
Starch flowable powder                                                    
                  225.3                                                   
Silicone fluid 350 centistokes                                            
                  1.7                                                     
______________________________________                                    
Formulation 5
Raloxifene capsule
______________________________________                                    
Ingredient        Quantity (mg/capsule)                                   
______________________________________                                    
Raloxifene        50                                                      
Starch, NF        150                                                     
Starch flowable powder                                                    
                  397                                                     
Silicone fluid 350 centistokes                                            
                  3.0                                                     
______________________________________                                    
The specific formulations above may be changed in compliance with the reasonable variations provided.
A tablet formulation is prepared using the ingredients below:
Formulation 6
Tablets
______________________________________                                    
Ingredient       Quantity (mg/tablet)                                     
______________________________________                                    
Active ingredient                                                         
                 0.1-1000                                                 
Cellulose, microcrystalline                                               
                 0-650                                                    
Silicon dioxide, fumed                                                    
                 0-650                                                    
Stearate acid    0-15                                                     
______________________________________                                    
The components are blended and compressed to form tablets.
Alternatively, tablets each containing 0.1-1000 mg of active ingredient are made up as follows:
Formulation 7
Tablets
______________________________________                                    
Ingredient          Quantity (mg/tablet)                                  
______________________________________                                    
Active ingredient   0.1-1000                                              
Starch              45                                                    
Cellulose, microcrystalline                                               
                    35                                                    
Polyvinylpyrrolidone                                                      
                    4                                                     
(as 10% solution in water)                                                
Sodium carboxymethyl cellulose                                            
                    4.5                                                   
Magnesium stearate  0.5                                                   
Talc                1                                                     
______________________________________                                    
The active ingredient, starch, and cellulose are passed through a No. 45 mesh U.S. sieve and mixed thoroughly. The solution of polyvinylpyrrolidone is mixed with the resultant powders which are then passed through a No. 14 mesh U.S. sieve. The granules so produced are dried at 50°-60° C. and passed through a No. 18 mesh U.S. sieve. The sodium carboxymethyl starch, magnesium stearate, and talc, previously passed through a No. 60 U.S. sieve, are then added to the granules which, after mixing, are compressed on a tablet machine to yield tablets.
Suspensions each containing 0.1-1000 mg of medicament per 5 mL dose are made as follows:
Formulation 8
Suspensions
______________________________________                                    
Ingredient          Quantity (mg/5 ml)                                    
______________________________________                                    
Active ingredient   0.1-1000   mg                                         
Sodium carboxymethyl cellulose                                            
                    50         mg                                         
Syrup               1.25       mg                                         
Benzoic acid solution                                                     
                    0.10       mL                                         
Flavor                         q.v.                                       
Color                          q.v.                                       
Purified water to   5          mL                                         
______________________________________                                    
The medicament is passed through a No. 45 mesh U.S. sieve and mixed with the sodium carboxymethyl cellulose and syrup to form a smooth paste. The benzoic acid solution, flavor, and color are diluted with some of the water and added, with stirring. Sufficient water is then added to produce the required volume.
TEST PROCEDURE
In Tests 1 and 2, effects of 14-day and 21-day administration of compounds of the invention on the growth of explanted endometrial tissue can be examined.
Test 1
Twelve to thirty adult CD strain female rats are used as test animals. They are divided into three groups of equal numbers. The estrous cycle of all animals is monitored. On the day of proestrus surgery is performed on each female. Females in each group have the left uterine horn removed, sectioned into small squares, and the squares are loosely sutured at various sites adjacent to the mesenteric blood flow. In addition, females in Group 2 have the ovaries removed.
On the day following surgery, animals in Groups 1 and 2 receive intraperitoneal injections of water for 14 days whereas animals in Group 3 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration. Following 14 days of treatment each female is killed and the endometrial explants, adrenals, remaining uterus, and ovaries, where applicable, are removed and prepared for histological examination. The ovaries and adrenals are weighed.
Test 2
Twelve to thirty adult CD strain female rats are used as test animals. They are divided into two equal groups. The estrous cycle of all animals is monitored. On the day of proestrus surgery is performed on each female. Females in each group have the left uterine horn removed, sectioned into small squares, and the squares are loosely sutured at various sites adjacent to the mesenteric blood flow.
Approximately 50 days following surgery, animals assigned to Group 1 receive intraperitoneal injections of water for 21 days whereas animals in Group 2 receive intraperitoneal injections of 1.0 mg of a compound of the invention per kilogram of body weight for the same duration. Following 21 days of treatment each female is killed and the endometrial explants and adrenals are removed and weighed. The explants are measured as an indication of growth. Estrous cycles are monitored.
Test 3
A. Surgical induction of endometriosis
Autographs of endometrial tissue are used to induce endometriosis in rats and/or rabbits. Female animals at reproductive maturity undergo bilateral oophorectomy and estrogen is supplied exogenously thus providing a specific and constant level of hormone. Autologous endometrial tissue is implanted in the peritoneum of 5-150 animals and estrogen supplied to induce growth of the explanted tissue. Treatment consisting of a compound of the invention is supplied by gastric lavage on a daily basis for 3-16 weeks and implants are removed and measured for growth or regression. At the time of sacrifice, the intact horn of the uterus is harvested to assess status of endometrium.
B. Implantation of human endometrial tissue in nude mice.
Tissue from human endometrial lesions is implanted into the peritoneum of sexually mature, castrated female nude mice. Exogenous estrogen is supplied to induce growth of the explanted tissue. In some cases the harvested endometrial cells are cultured in vitro prior to implantation. Treatment consisting of a compound of the invention is supplied by gastric lavage on a daily basis for 3-16 weeks and implants are removed and measured for growth or regression. At the time of sacrifice, the uteri is harvested to assess the status of the intact endometrium.
Test 4
A. Tissue from human endometrial lesions is harvested, and maintained in vitro as primary nontransformed cultures. Surgical specimens are pushed through a sterile mesh or sieve or alternately teased apart from surrounding tissue to produce a single cell suspension. Cells are maintained in media containing 10% serum and antibiotics. Rates of growth in the presence and absence of estrogen are determined. Cells are assayed for their ability to produce complement component C3 and their response to growth factors and growth hormone. In vitro cultures are assessed for their proliferative response following treatment with progestins, GnRH, a compound of the invention and vehicle. Levels of steroid hormone receptors are assessed weekly to determine whether important cell characteristics are maintained in vitro. Tissue from 5-25 patients is utilized.
Activity in any of the above assays indicates that the compounds of the invention are useful in the treatment of endometriosis.

Claims (3)

We claim:
1. A method of inhibiting endometriosis comprising administering to a human in need of treatment an effective amount of a compound having the formula ##STR5## Wherein R1 and R3 are independently hydrogen, --CH3, ##STR6## wherein Ar is optionally substituted phenyl;
R2 is selected from the group consisting of pyrrolidine and piperidino; or a pharmaceutically acceptable salt of solvate thereof.
2. The method of claim 1 wherein said compound is the hydrochloride salt thereof.
3. The method of claim 1 wherein said compound is ##STR7## or its hydrochloride salt.
US08/138,643 1993-10-15 1993-10-15 Methods for inhibiting endometriosis Expired - Lifetime US5461065A (en)

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Application Number Priority Date Filing Date Title
US08/138,643 US5461065A (en) 1993-10-15 1993-10-15 Methods for inhibiting endometriosis
UA94105917A UA26930C2 (en) 1993-10-15 1994-10-12 MEANS FOR DEFINITION OF ECHOMETRIOSIS
SG1996008246A SG43319A1 (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
ES94307528T ES2157957T3 (en) 1993-10-15 1994-10-13 PROCEDURES TO INHIBIT ENDOMETRIOSIS.
DE69427800T DE69427800T2 (en) 1993-10-15 1994-10-13 Endometriosis inhibition method
CA002118092A CA2118092A1 (en) 1993-10-15 1994-10-13 Methods of inhibiting endometriosis
DK94307528T DK0652005T3 (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
TW083109467A TW296382B (en) 1993-10-15 1994-10-13
NO19943879A NO311242B1 (en) 1993-10-15 1994-10-13 Use of 2-phenyl-3-aroylbenzothiophenes for the preparation of a drug for inhibiting endometriosis
PH49186A PH31261A (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis.
RU94036772/14A RU2157203C2 (en) 1993-10-15 1994-10-13 Utilization of 2-phenyl-3-aroylbenzothiophenes for inhibition of endometriosis
KR1019940026164A KR950010893A (en) 1993-10-15 1994-10-13 How to suppress endometriosis
CN94117125A CN1049335C (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
SI9430388T SI0652005T1 (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
EP94307528A EP0652005B1 (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
ZA948029A ZA948029B (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
IL11128494A IL111284A (en) 1993-10-15 1994-10-13 2-phenyl-3-aroylbenzothiophenes for use as medicaments for inhibiting endometriosis
AT94307528T ATE203404T1 (en) 1993-10-15 1994-10-13 METHOD OF INHIBITING ENDOMETRIOSIS
HU9402959A HUT71235A (en) 1993-10-15 1994-10-13 Pharmaceutical compositions against endometriosis containing 2-phenyl-3-aroil-benzotiophene derivatives and process for their preparation
JP6247764A JPH07188014A (en) 1993-10-15 1994-10-13 Method of suppressing endometriosis
AU75787/94A AU677700B2 (en) 1993-10-15 1994-10-13 Methods for inhibiting endometriosis
CZ19942537A CZ287246B6 (en) 1993-10-15 1994-10-13 Medicament for inhibiting endometriosis
PT94307528T PT652005E (en) 1993-10-15 1994-10-13 METHOD FOR ENDOMETRIOSIS INHIBITION
NZ264677A NZ264677A (en) 1993-10-15 1994-10-13 Use of substituted benzothiophenes to prepare pharmaceutical compositions for inhibiting endometriosis
US08/422,387 US5693656A (en) 1993-10-15 1995-04-14 Methods for inhibiting endometriosis
GR20010401841T GR3036971T3 (en) 1993-10-15 2001-10-22 Methods for inhibiting endometriosis.

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